Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Division of Infectious Diseases, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
Am J Trop Med Hyg. 2023 Oct 30;109(6):1311-1318. doi: 10.4269/ajtmh.23-0146. Print 2023 Dec 6.
In East Asia, severe fever with thrombocytopenia syndrome (SFTS) and scrub typhus, which are common endemic tick- and mite-mediated diseases sharing common clinical manifestations, are becoming public health concerns. However, there are limited data on the comparative immunopathogenesis between the two diseases. We compared the cytokine profiles of SFTS and scrub typhus to further elucidate immune responses that occur during the disease courses. We prospectively enrolled 44 patients with confirmed SFTS and 49 patients with scrub typhus from July 2015 to December 2020. In addition, 10 healthy volunteers were enrolled as healthy controls. A cytometric bead array was used to analyze plasma samples for 16 cytokines. A total of 68 plasma samples, including 31 (45.6%) from patients with SFTS and 37 (54.4%) from patients with scrub typhus, were available for cytokine measurement. There were three cytokine expression patterns: increased levels in both SFTS and scrub typhus (interleukin 6 [IL-6], IL-10, interferon gamma induced protein 10 [IP-10], and granulocyte-macrophage colony-stimulating factor [GM-CSF]), highest levels in SFTS (interferon alpha [IFN-α], IFN-γ, granulocyte-CSF [G-CSF], monocyte chemotactic protein 1 [MCP-1], macrophage inflammatory protein 1α [MIP-1α], and IL-8), and distinct levels in scrub typhus (IL-12p40, tumor necrosis factor alpha [TNFα], IL-1β, regulated on activation and normally T-cell expressed and secreted [RANTES], IL-17A, and vascular endothelial growth factor [VEGF]). Although patients with acute SFTS and scrub typhus exhibited partly shared expression patterns of cytokines related to disease severity, the different profiles of cytokines and chemokines might contribute to higher mortality in SFTS than in scrub typhus. Discrete patterns of helper T cell-related cytokines and VEGF might reflect differences in CD4 T-cell responses and vascular damage between these diseases.
在东亚，严重发热伴血小板减少综合征（SFTS）和恙虫病是两种常见的地方性蜱媒和螨媒疾病，具有共同的临床表现，成为公共卫生关注的问题。然而，关于这两种疾病的比较免疫发病机制的数据有限。我们比较了 SFTS 和恙虫病的细胞因子谱，以进一步阐明疾病过程中发生的免疫反应。我们前瞻性地招募了 2015 年 7 月至 2020 年 12 月期间确诊的 44 例 SFTS 患者和 49 例恙虫病患者。此外，还招募了 10 名健康志愿者作为健康对照组。使用流式细胞术微珠阵列分析血浆样本中的 16 种细胞因子。共获得 68 份血浆样本，其中 31 份（45.6%）来自 SFTS 患者，37 份（54.4%）来自恙虫病患者，可用于细胞因子测量。有三种细胞因子表达模式：SFTS 和恙虫病均升高（白细胞介素 6 [IL-6]、IL-10、干扰素γ诱导蛋白 10 [IP-10]和粒细胞-巨噬细胞集落刺激因子 [GM-CSF]）、SFTS 中最高（干扰素-α[IFN-α]、IFN-γ、粒细胞集落刺激因子 [G-CSF]、单核细胞趋化蛋白 1 [MCP-1]、巨噬细胞炎性蛋白 1α [MIP-1α]和白细胞介素 8 [IL-8]）和恙虫病中独特（白细胞介素 12p40、肿瘤坏死因子-α[TNFα]、白细胞介素 1β、调节激活正常 T 细胞表达和分泌[RANTES]、白细胞介素 17A 和血管内皮生长因子 [VEGF]）。尽管急性 SFTS 和恙虫病患者表现出与疾病严重程度相关的细胞因子表达模式部分重叠，但细胞因子和趋化因子的不同模式可能导致 SFTS 的死亡率高于恙虫病。辅助性 T 细胞相关细胞因子和 VEGF 的离散模式可能反映了这些疾病中 CD4 T 细胞反应和血管损伤的差异。
